低剂量替格瑞洛在颅内动脉瘤支架辅助栓塞术后的应用

向阳芳; 刘羽; 周志凌; 程光森

doi:10.11659/jjssx.11E023126

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低剂量替格瑞洛在颅内动脉瘤支架辅助栓塞术后的应用

临床研究 | 更新时间：2024-12-10

- 低剂量替格瑞洛在颅内动脉瘤支架辅助栓塞术后的应用
- Application of low-dose ticagrelor after stent-assisted embolization of intracranial aneurysm
- 局解手术学杂志 2024年33卷第12期页码：1073-1076
- 作者机构：
  
  1.珠海市人民医院（暨南大学珠海临床医学院）药学部，广东珠海 519000
  2.珠海市人民医院（暨南大学珠海临床医学院）脑血管病科，广东珠海 519000
- 作者简介：
  
  程光森，E-mail：cgs58@126.com
- 基金信息：
  
  珠海市医学科研基金项目(2220009000306-03)
- DOI：10.11659/jjssx.11E023126
  中图分类号： R651.1+2
- 纸质出版日期：2024-12-25，
  
  收稿日期：2023-11-28，
- 稿件说明：
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向阳芳,刘羽,周志凌等.低剂量替格瑞洛在颅内动脉瘤支架辅助栓塞术后的应用[J].局解手术学杂志,2024,33(12):1073-1076.

XIANG Yang-fang,LIU Yu,ZHOU Zhi-ling,et al.Application of low-dose ticagrelor after stent-assisted embolization of intracranial aneurysm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1073-1076.
向阳芳,刘羽,周志凌等.低剂量替格瑞洛在颅内动脉瘤支架辅助栓塞术后的应用[J].局解手术学杂志,2024,33(12):1073-1076. DOI： 10.11659/jjssx.11E023126.

XIANG Yang-fang,LIU Yu,ZHOU Zhi-ling,et al.Application of low-dose ticagrelor after stent-assisted embolization of intracranial aneurysm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1073-1076. DOI： 10.11659/jjssx.11E023126.

摘要

目的

探讨低剂量替格瑞洛联合阿司匹林在颅内动脉瘤患者支架辅助栓塞术后的应用效果。

方法

回顾性分析2021年1月至2023年1月在我院接受支架辅助栓塞治疗的未破裂颅内动脉瘤患者的临床资料，根据患者术前双联抗血小板治疗方案分为替格瑞洛组[阿司匹林（100 mg，每日1次）+低剂量替格瑞洛（每次60 mg，每日2次）]和氯吡格雷组[阿司匹林（100 mg，每日1次）+氯吡格雷（75 mg，每日1次）]。共纳入158例行支架辅助栓塞治疗的患者，其中替格瑞洛组84例，氯吡格雷组74例。术后对患者进行3个月的随访，观察2组患者的缺血事件及出血事件发生情况并进行比较。

结果

替格瑞洛组与氯吡格雷组术后3个月的出血事件发生率（11.9%

vs.

12.2%）比较，差异无统计学意义（

0.05）；替格瑞洛组和氯吡格雷组术后3个月的缺血事件发生率（11.9%

vs.

25.7%）比较，差异具有统计学意义（

0.05）。多因素

Cox

回归分析显示，低剂量替格瑞洛（

=0.44，95%

：0.21~0.93，

=0.035）是支架辅助栓塞术后缺血事件的保护因素。

结论

与氯吡格雷相比，颅内动脉瘤支架辅助栓塞术后应用低剂量替格瑞洛（每次60 mg，每日2次）可显著降低术后缺血性卒中事件发生率，低剂量替格瑞洛联合阿司匹林可作为颅内动脉瘤支架辅助栓塞术后双联抗血小板治疗方案。

Abstract

Objective

To investigate the application effect of low-dose ticagrelor combined with aspirin in patients with intracranial aneurysm after stent-assisted embolization.

Methods

The clinical data of patients with unruptured intracranial aneurysm who underwent stent-assisted embolization in our hospital from January 2021 to January 2023 were retrospectively analyzed and divided into the ticagrelor group ［aspirin（100 mg， once a day）+low-dose ticagrelor （60 mg， twice a day）］ and the clopidogrel group ［aspirin （100 mg， once a day）+clopidogrel （75 mg， once a day）］ according to the preoperative dual antiplatelet therapy regimen. A total of 158 patients who underwent stent-assisted embolization were included， including 84 patients in the ticagrelor group and 74 patients in the clopidogrel group.The patients were followed up for 3 months after surgery，and the occurrence of ischemic events and hemorrhagic events in the two groups were observed and compared.

Results

There was no statistically significant difference in the incidence of hemorrhagic events 3 months after surgery （11.9%

.12.2%） between the ticagrelor group and the clopidogrel group（

0.05）.There was a statistically significant difference in the incidence of ischemic events 3 months after surgery（11.9%

. 25.7%） between the ticagrelor group and theclopidogrel group （

0.05）. Multivariate

Cox

regression analysis showed that low-dose ticagrelor （

=0.44， 95%

： 0.21 to 0.93，

=0.035） was a protective factor for ischemic events after stent-assisted embolization.

Conclusion

Compared with clopidogrel， the application of low-dose ticagrelor （60 mg， twice a day） after stent-assisted embolization of intracranial aneurysm can significantly reduce the incidence of postoperative ischemic stroke events， and low-dose ticagrelor combined with aspirin can be used as a dual antiplatelet therapy regimen after stent-assisted embolization of intracranial aneurysm.

关键词

颅内动脉瘤支架辅助栓塞低剂量替格瑞洛

Keywords

intracranial aneurysmstent-assisted embolizationlow-dose ticagrelor

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